Micro Man Flashcards

1
Q

Gram negative ‘coliforms’

A

E coli, Klebsiella, Enterobacter, Proteus

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2
Q

Gram negative ‘coliforms’ sensitivity

A

Gentamicin

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3
Q

Extended Spectrum Beta Lactamases (ESBL) sensitivities

A

Temocillin, pivmecillinam (& meropenem)

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4
Q

Why is metronidazole not needed with pip-tazobactam or co-amoxiclav

A

they have anaerobic cover

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5
Q

Temocillin & aztreonam have no ______ or gram ______ cover

A

Temocillin & aztreonam have no anaerobic or gram positive cover

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6
Q

Anaerobes are generally sensitive to =

A

metronidazole (and co-amoxiclav, clindamycin, pip-tazobactam & meropenem)

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7
Q

Gram positives like Staph aureus (MSSA, MRSA), streps & enterococci are sensitive to

A

vancomycin (except VREs): use restricted to penicillin allergy or penicillin resistant strains

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8
Q

MRSA is resistant to all

A

beta-lactams (penicillins, flucloxacillin, pip-tazobactam,

cephalosporins & meropenem)

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9
Q

Beta-haemolytic streps (groups A C G) are sensitive to

A

penicillin & flucloxacillin

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10
Q

Pathogens in meningitis

A

pneumococcus, meningococcus and if > 60 listeria

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11
Q

pathogens in encephalitis

A

herpes simplex

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12
Q

what are pneumococci and meningococci similar sensitive to?

A

penicillin

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13
Q

why is ceftriaxone chosen in meningitis?

A

need for high CSF levels to maintained and the ease of dosing (twice a day) provides better cover for the rare strain that might have borderline sensitivity to penicillin

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14
Q

what is listeria resistant to?

A

cephalosporins

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15
Q

what is listeria sensitive to?

A

amoxicillin: high dose and frequent dosing

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16
Q

what is herpes simplex sensitive to?

A

IV aciclovir

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17
Q

pathogens in epiglottitis?

A

haemophilus influenzae, streptococci

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18
Q

pathogens in tonsilitis

A

group a streptococci

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19
Q

pathogens in sinusitis

A

pneumococcus

20
Q

pathogens in acute otitis media

A

pneumococcus, haemophilus influenzae

21
Q

amoxicillin has better absorption when given

22
Q

what are haemophilus influenzae sensitive to

A

amoxicillin (not penicllin)

23
Q

why are life threatening haemophilus influenzae treated with ceftriaxone

A

for the rare cases of amoxicillin resistance

24
Q

organisms in CAP

A

CAP Mild/moderate: pneumococcus, Haemophilus influenzae

CAP Severe: as above but possible coliforms and atypicals such as Legionella, Mycoplasma, Chlamydia pneumoniae,
Coxiella ;

Remember Staph aureus pneumonia post influenza and the PVL producing strains of Staph aureus that can produce severe pneumonia in children and young adults especially please contact micro/make clear on form to add extra tests for this

25
acute exacerbation of COPD organisms
Pneumococcus, haemophilus influenzae
26
HAP organisms
pneumococcus, Haemophilus influenzae and coliforms. | Legionella can be hospital acquired.
27
Co-amoxiclav provides cover for most.....
Haemophilus influenzae & coliforms for those with severe infection (not ESBLs or CPEs though)
28
why is doxycycline used in pneumonia
for atypical cover
29
native valve acute
Staph aureus: take 2 sets blood cultures & start antibiotic within the hour
30
Native valve subacute
viridans streptococci, enterococci :3 sets blood cultures 6 hours apart if patient stable
31
Prosthetic valve
MRSA (resistant to flucloxacillin and all beta lactams); coagulase negative staphylococc
32
Indolent presentation________/_____ more likely: synergistic ____/_____ (1mg/kg bd) pending culture results
Enterococci/streps | amox/gent
33
Coagulase negative staphylococci sensitivity
vancomycin, gentamicin (1mg/kg bd) & rifampicin (started 3-5 days after vancomycin) is used to ensure cover, killing & penetration
34
most enterococci are sensitive to ______
amoxicillin
35
peritonitis/biliary tract sepsis/intrabdominal organisms
polymicrobial coliforms anaerobes enterococci
36
Spontaneous bacterial peritionitis
coliforms +/- anaerobes, sometimes strep pneumonia
37
anaerobe sensitivity
metronidazole
38
coliform sensitivity
gentamicin and aztreonam
39
ESBLs sensitivity
>resistant to most penicillins & cephalosporins including aztreonam, co-amoxiclav & pip-tazobactam > sensitive to temocillin (& meropenem available on infection specialist advice only) >Sensitivity of ESBLs to co-trimoxazole is unpredictable
40
organisms in female uncomplicated lower UTI
coliforms | enterococci
41
male (no catheter) organisms
coliforms | enterococci
42
complicated UTI
coliforms pseudomonas aeruginosa enterococci
43
why isnt nitro used in complicated UTI
no kidney tissue penetration & is not excreted in urine in renal impairment
44
cellulitis organisms
Staph aureus, group A & other beta-haemolytic streptococci
45
Diabetic foot acute
Staph aureus
46
Diabetic foot acute on chronic polymicrobial
Staph aureus, coliforms & anaerobes
47
Flucloxacillin will cover .....; so ..... is not required in addition
beta-haemolytic streptococci ( A C &G) | penicillin